Allied Health Group, LTD
Organization Active NPI Chiropractor · Normal, IL
NPI 1467574731 · NPPES record last updated Jul 25, 2023
Key facts
- NPI
- 1467574731
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 038.009648 (IL)
- Legal business name
- ALLIED HEALTH GROUP, LTD
- Practice address
- 1603 Visa Dr
Normal, IL 61761-2131 - Phone
- (309) 268-9000
- Fax
- (309) 268-9003
- NPI assigned
- Apr 6, 2007
- Organization subpart
- No
Authorized official
- Name
- Patricia Zvonar
- Title
- Billing Specialist
- Phone
- (309) 268-9000
Practitioners 5
-
Jeffrey Lee Dickhut, D.C.
-
Jay M Bersche, D.C.
-
John Marvin Everingham, D.C.
-
Carolyn Hagerty, FNP-BC
-
Hong Xuan Vo, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071114000041 | IL | Part B Supplier - Clinic/Group Practice | 9032207733 |
Receives reassigned benefits from 5 practitioners Practice locations: Normal, IL |
National Provider Directory
Locations
1603 Visa Dr
Ste 3
Normal, IL 61761
Phone (309) 268-9000
1603 Visa Dr
Normal, IL 61761
Phone (309) 268-9000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 038.009648 | IL | Yes |
| Pain Medicine Physician |
208VP0000X | 038.009648 | IL |
Addresses
Primary practice location
1603 Visa Dr
Normal, IL 61761-2131
Mailing address
1603 Visa Dr
Normal, IL 61761-2131
Phone (309) 268-9000
Other names
- Central IL Spine
Other providers in Normal, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 25, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.